Salvia miltiorrhiza: insights on the protective effect and mechanism of myocardial ischemia-reperfusion injury

Myocardial ischemia-reperfusion injury (MIRI), a common secondary complication of cardiovascular diseases (CVDs), leads to significant psychological and physiological distress in patients. Pathophysiological reactions including inflammatory response, oxidative stress injury, platelet aggregation, vascular endothelial dysfunction, and programmed cell death are involved in the pathogenesis of MIRI. Prolonged use of conventional therapies (e.g., NSAIDs, calcium channel blockers, beta-blockers, and antiplatelet agents) may exacerbate cardiovascular damage due to adverse effects. Thus, identifying complementary and alternative therapies with better efficacy and safety profile is imperative. Unlike single-target pharmacological approaches, Salvia miltiorrhiza Bunge exhibits pleiotropic effects by modulating multiple pathways, including inflammation, oxidative stress, and vascular function. This review summarizes the protective mechanisms of Salvia miltiorrhiza against MIRI, highlighting its potential as a translational therapy for MIRI and guiding future preclinical studies.